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ENT > Microbiology > Flashcards

Microbiology Flashcards

1
Q

How is herpes simplex virus transmitted?

A

Saliva

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2
Q

Who often gets herpes simplex virus?

A

Pre-school children

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3
Q

How does gingivostomatitis present?

A

Vesicles and ulcers may have systemic upset and lymphadenopathy if it spreads beyond the mouth

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4
Q

How is herpes simplex virus treated?

A

Acyclovir

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5
Q

Name the investigation that can be used to diagnose herpes

A

PCR for viral DNA

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6
Q

Where does herpes virus sit inactive?

A

In sensory nerve cells

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7
Q

What is herpangina?

A

Vesicles/ulcers on the soft palate due to coxsakie virus

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8
Q

Who usually gets herpangina?

A

Young children

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9
Q

How is herpangina diagnosed?

A

PCR swab

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10
Q

How does primary syphilis present?

A

Painless indurated ulcer at site of entry of bacterium can be genital or oral lesions

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11
Q

What is apthous disease?

A

Non-viral self limiting recurrent painful ulcers of the mouth

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12
Q

Describe apthous ulcers

A

Round of ovoid with inflammatory halos confined to the mouth

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13
Q

How long do apthous ulcers generally last?

A

3 weeks

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14
Q

What diseases are associated with recurrent ulcers?

A
  • bechet’s
  • coeliac/IBD
  • reiter’s disease
  • drug reactions
  • skin diseases
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15
Q

Describe bechet’s disease

A

Recurrent oral/genital ulcers, uveitis may also involve visceral organs

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16
Q

Where is bechet’s disease most commonly found?

A

Middle east/asia

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17
Q

When should infectious mononucleosis be considered?

A

In a 15-25 year old patient with a sore throat persisting for 2 weeks

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18
Q

What causes infectious mononucleosis?

A

Epstein Barr Virus

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19
Q

State the complications of a sore throat

A
  • otitis media
  • peri-tonsillar abscess
  • para-pharyngeal abscess
  • mastoiditis
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20
Q

When is admission for a sore throat required?

A
  • suspected throat cancer
  • > 3/4 weeks of dysphagia
  • Red/white patches, ulceration or swelling
  • stridor or respiratory problems
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21
Q

What portion of sore throats are viral?

A

2/3

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22
Q

What is the most common cause of a bacterial tonsillitis?

A

Strep pyogenes

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23
Q

How is acute follicular tonsillitis treated?

A

Penicillin - phenoxymethylpenicillin

24
Q

Name two late complications of acute follicular tonsillitis

A
  • rheumatic fever

- glomerulonephritis

25
Q

Name two criteria that can be used to assess the need for antibiotics

A

CENTOR

PAIN

26
Q

Describe the centor criteria

A

Tonsillar exudate
Tender anterior cervical lymph nodes
History of fever
No cough

27
Q

Describe the pain criteria

A

Purulence
Attend rapidly
Inflamed tonsils
No cough

28
Q

What must be done for a patient on a DMARD?

A

Full blood count - beware of agranulocytosis

29
Q

Describe the appearance of diphtheria

A

Severe acute sore throat with a grey/white membrane across the pharynx

30
Q

What is special about diphtheria?

A

Produces exotoxin - cardiotoxic and neurotoxic

31
Q

Where is diphtheria most common?

A

Russia - huge decrease since vaccination

32
Q

How is diphtheria treated?

A

Antitoxin, supportive care, penicillin/erythromycin

33
Q

State the infectious mononucleosis triad

A
  • fever
  • pharyngitis
  • lymphadenopathy
34
Q

What are the signs/symptoms of EBV?

A 
Jaundice/hepatitis
Rash
Haematology (leucocytosis, atypical lymphocytes)
Splenomegaly 
Palatal petechiae
35
Q

What is the treatment for EBV?

A

Self limiting, bed rest and paracetamol

36
Q

What must never be prescribe to a patient with tonsillitis and why?

A

Amoxicillin - macular rash can occur is EBV present

37
Q

What are the complications of EBV?

A

Anaemia, thrombocytopenia, splenic rupture, hepatitis, airway obstruction, lymphoma

38
Q

What investigations can be done on a patient with suspected EBV?

A

IgM, hetrophil antibody, blood count, LFTs

39
Q

Describe oral candida

A

White patches on red, raw mucous membranes in the throat and mouth

40
Q

What can cause oral thrush?

A

Antibiotics, immunosuppressed, smoking, steroids

41
Q

How is oral thrush treated?

A

Nystatin or fluconazole

42
Q

Describe the histology of cytomegalovirus in comparison to EBV

A

No heterophil antibody and fewer atypical lymphocytes

43
Q

What is acute otitis media often due to?

A

Upper respiratory tract infection moves through eustachian tube

44
Q

When is a swab indicated in otitis media?

A

When the ear drum perforates

45
Q

What bacteria commonly cause acute otitis media?

A

H.influenza, strep pneumonia, strep pyogenes,

46
Q

What is otitis externa?

A

Inflammation of the outer ear canal

47
Q

How does otitis externa present?

A

Red/swollen skin of ear canal
Itchy becomes sore and painful
Increased wax/discharge
May affect hearing

48
Q

Name the bacteria causes of otitis externa

A

Staph aureus, proteus, pseudomonas

49
Q

Name the fungal causes of otitis externa

A

Aspergillus candida

50
Q

How it otitis externa managed?

A

Culture dependent - topical clotrimazole

Topical aural toilet

51
Q

What is malignant otitis?

A

Extension of otitis external into bone surrounding ear canal (mastoid and temporal bone) - can become osteomyelitis and involve skull and meninges

52
Q

What are the signs/symptoms of malignant otitis?

A

Pain, headache, granulation tissue at bone-cartilage junction, exposed bone, facial nerve palsy

53
Q

What investigations should be carried out on a patient with suspected malignant otitis?

A

Plasma viscosity/CRP, radiological imagine, biopsy and culture

54
Q

What are the risk factors for malignant otitis?

A

Diabetes

Head and neck radiotherapy

55
Q

Describe the presentation of acute sinusitis

A

Mild discomfort over frontal/maxillary sinuses due to congestion usually with URTI

56
Q

What indicates acute sinusitis is bacterial?

A

Pain, tenderness with purulent nasal discharge

57
Q

If a patient has acute sinusitis for more than 10 days or is very systemically unwell what should be done?

A

Phenoxymethylpenicillin or doxycycline

ENT (11 decks)

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